A hysterectomy is a surgical procedure to remove a woman’s uterus (womb). The uterus is where a baby grows when a woman is pregnant. After you have had a hysterectomy, you will no longer have periods and cannot become pregnant.
Reasons for Needing a Hysterectomy
A woman may require a hysterectomy for a number of reasons, and except in the case of cancer, it is usually carried out as a last resort. Reasons why a hysterectomy may be considered include:
Endometriosis is a painful condition with abnormal growth of cells (endometrial cells) where tissue similar to the tissue that forms the lining of your uterus grows outside of your uterine cavity, usually on other organs of the pelvis such as the ovaries and bowels, although it can spread beyond the pelvic region.
The exact cause of endometriosis is unknown, but is more common in women who are experiencing infertility. However, the condition does not necessarily cause infertility. Symptoms can include:
- Painful intercourse
- Pelvic pain which is worse during menstruation
- Painful urination and bowel movements
Fibroids are benign swellings or lumps that grow on the uterus. They can become quite large and press on the bladder, causing urinary symptoms, heavy period or painful periods, and severe abdominal pain. Fibroids are very common and often do not always cause any symptoms.
Genitourinary prolapse, also known as female pelvic organ prolapse is a common gynaecological condition with varying severity. The uterus or parts of the vaginal wall descent and protrude close to or through the vagina and is most common after menopause when the tissues that support the uterus tend to become thinner and weaker.
Painful Menstrual Periods
Most women will experience menstrual cramps when their periods begin (or just before) which can continue for 2-3 days. Symptoms can range in severity from mild discomfort to severe pain that interferes with daily life.
Painful periods are also known as dysmenorrhea and can be categorised as primary or secondary. Primary dysmenorrhea occurs in women who experience pain before and during menstruation, whereas secondary dysmenorrhea occurs later in life after you have had normal periods. The following conditions can contribute to painful periods:
- Heavy menstrual periods
- Starting your periods at an early age (before 11 years)
Heavy Menstrual Periods
Heavy periods in women can affect day to day activities, and are often accompanied with painful cramps and blood clots. Each woman’s menstrual flow and cycle are different, but on average, a woman will lose 30-40ml of blood during her period, whereas a woman with heavy bleeding can lose up to 80ml. This can often lead to anaemia, and so it is recommended you see a doctor if you are experiencing an abnormally heavy flow.
If you develop ovarian cancer, cervical cancer, uterine cancer or cancer of the fallopian tubes, a hysterectomy will likely be recommended. Your doctor will be able to advise on the best course of action for you.
Types of Hysterectomy
The type of hysterectomy you need will depend on the severity of the problem.
A partial hysterectomy, also known as a subtotal or supracervical hysterectomy removes only the upper section of the uterus, leaving the uterus in place. Your doctor may remove your ovaries at the same time, but this decision depends on the reason for carrying out the hysterectomy. Removing the ovaries will reduce your risk of ovarian cancer, but it will lead to you going through the menopause. However, if your ovaries are not removed, you may still go through the menopause earlier compared to if you have not had a hysterectomy.
Your gynaecologist will be able to advise you of the pros and cons to having your ovaries removed in greater detail.
A total hysterectomy is the most common type of hysterectomy and involves removing all of the uterus, including the cervix. As with a partial hysterectomy, the ovaries, along with the fallopian tubes may or may not be removed. If you undergo a total hysterectomy, you will no longer be required to have smear tests; however, you should continue to have regular well women check-ups.
A radical hysterectomy, also known as Wertheim’s hysterectomy involves removing all of the uterus, the cervix, fallopian tubes, ovaries, the tissue on both sides of the cervix, the upper part of the vagina and the lymph nodes. A radical hysterectomy is usually performed if a woman has been diagnosed with cancer.
How is a Hysterectomy Performed?
A hysterectomy can be performed in a number of ways depending on your medical history and your reasons for requiring surgery. All methods of hysterectomy require either a general or local anaesthetic. A local anaesthetic will often be combined with a sedative which will help you feel relaxed and sleepy during the procedure. Types of hysterectomy include:
This is carried out by making a small incision in the vagina to remove the uterus. There are no external cuts and no visible scars.
Your doctor will make a cut in your abdomen (stomach) to remove your uterus. The incision may be horizontal or vertical, with both types healing well and leaving a small scar.
A laparoscopic hysterectomy involves the surgeon using a tiny instrument (laparoscope) with high intensity light and a small high resolution camera in order to see your pelvic organs. The laparoscope is inserted through small cuts (usually 3 or 4) made in the abdomen which allows for the uterus to be cut into small pieces. The uterus is then removed, either through the abdomen or vagina.
Recovering from a Hysterectomy
Recovery from a hysterectomy can take some time, depending on the type of procedure performed. You will be required to stay in hospital, anything from 2-5 nights, particularly if the hysterectomy was performed due to cancer. Your vital signs will be monitored, such as your breathing and heart rate, and it is likely that you will have a catheter inserted for a couple of days (a small tube going into your bladder which drains urine). You will be able to eat and drink within a few hours of your operation, and you will be encouraged to walk around the hospital as soon as possible in order to prevent blood clots in the legs.
You will be given painkillers for the first few days which may also be prescribed for you to take home. It is common to have some light bleeding from the vagina which can last for up to 6 weeks. Wearing a menstrual pad can help prevent your clothing from becoming stained. If you have had stitches which need to be removed, these are usually taken out between 5-7 days after your operation.
It will take some time before you can return to normal activities, but upon your return home, it is important that you keep active. This can include walking around your house or local neighbourhood, but you should avoid certain activities during your recovery, usually for a minimum of 4-6 weeks. These include:
- Lifting heavy objects
- Sexual intercourse
- Pushing and pulling household items such as a vacuum cleaner
In general, you should be able to return to normal activities within 3-4 weeks if you have had a vaginal or laparoscopic hysterectomy, whereas recovery from an abdominal hysterectomy can take between 4-6 weeks.
Risks and Complications
A hysterectomy is considered a fairly safe procedure, and most women who undergo surgery have no serious complications. However, it is considered a major surgery, and like all others, there are associated risks. These include:
- Risk of infection
- Adverse reaction to the anaesthetic
- Blood clots
- Urinary incontinence
- Vaginal prolapse
- Vaginal fistula (an abnormal connection that forms between the vagina, bladder or rectum)
- Chronic pain
- Injury around surrounding tissues or organs such as the bladder, intestines and blood vessels
What to Expect Following a Hysterectomy
A woman is likely to go through menopause at an earlier age than she otherwise would have expected, particularly if her ovaries were removed. However, the majority of women find the operation successful in curing or improving the condition they were experiencing beforehand.
You can use your private medical insurance or pay for your Hysterectomy treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Hatfield Hospital.
Why One Hatfield
- Modern purpose-built hospital opened in December 2017
- Fast access to diagnostics including MRI, X-ray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience
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Gynaecology Pricing Guide at One Hatfield Hospital
This is a list of guide prices for some of common Gynaecology treatments and procedures.
|Treatment||Guide Price||Monthly from|
|Hysterectomy - abdominal||£7,250||£162|
|Repair of Prolapsed Vagina||£6,620||£146.36|